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Pregnancy Category: C
Induction of mid-trimester abortion.Treatment of postpartum hemorrhage that has not responded to conventional therapy.
Causes uterine contractions by directly stimulating the myometrium.
Expulsion of fetus.
Control of postpartum bleeding.
Absorption: Well absorbed following IM administration.
Metabolism and Excretion: Unknown.
Time/action profile (peak noted as mean abortion time)
Contraindicated in: Hypersensitivity; Acute pelvic inflammatory disease; Active pulmonary, renal, or hepatic disease.
Use Cautiously in: Uterine scarring; Asthma; Hypotension; Hypertension; Cardiac disease; Adrenal disease; Anemia; Jaundice; Diabetes mellitus; Epilepsy.
Adverse Reactions/Side Effects
Central nervous system
- diarrhea (most frequent)
- nausea (most frequent)
- vomiting (most frequent)
- abdominal pain
- uterine rupture (life-threatening)
- fever (most frequent)
Drug-Drug interactionAugments the effects of other oxytocic agents.
Intramuscular (Adults) 100 mcg.
Intramuscular (Adults) 250 mcg every 1.5–3.5 hr depending upon uterine response; may be increased to 500 mcg if several doses of 250 mcg produce inadequate response (not to exceed 2 days of continuous therapy or total dose of 12 mg).
Refractory Postpartum Uterine Bleeding
Intramuscular (Adults) 250 mcg; may be repeated every 15–90 min (total dose not to exceed 2 mg).
Injection: 250 mcg/mL
- Monitor frequency, duration, and force of contractions and uterine resting tone. Notify physician or other health care professional if contractions are absent or last more than 1 min.
- Monitor temperature, pulse, and BP periodically throughout course of therapy. Large dose may cause hypertension. Temperature elevation beginning 1 to 16 hr after initiation of therapy and lasting for several hours is not unusual.
- Auscultate breath sounds. Wheezing and sensation of chest tightness may indicate hypersensitivity reaction.
- Assess for nausea, vomiting, and diarrhea. Vomiting and diarrhea occur in approximately two-thirds of patients. Premedication with antiemetic and antidiarrheal is recommended.
- Monitor amount and type of vaginal discharge. Notify physician or other health care professional immediately if symptoms of hemorrhage (increased bleeding, hypotension, pallor, tachycardia) occur.
Potential Nursing DiagnosesDeficient knowledge, related to medication regimen (Patient/Family Teaching)
- Avoid contact with skin. Thoroughly wash skin immediately after spillage.
- Opioid analgesic may be given for uterine cramping.
- Store in refrigerator.
- Intramuscular: Administer deep IM. Dose may be repeated every 1.5–3.5 hr. Rotate sites.
- Explain purpose of vaginal examinations (to assess for trauma to cervix).
- Instruct patient to notify health care professional immediately if fever and chills, foul-smelling vaginal discharge, lower abdominal pain, or increased bleeding occurs.
- Complete abortion.
- Control of postpartum or post-abortal hemorrhage.